Occupational Exposure to Airborne Fiberglass Fibers Generated during Orthopedic Cast Removal: Exposure Assessment, SEM–EDX Characterization and Respiratory Health among Healthcare Workers

Vollständiger Abstract

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Orthopedic cast removal with oscillating saws may release airborne fiberglass fibers and dust into healthcare workers' breathing zones. This multicentre comparative cross-sectional study characterized airborne fiberglass fiber exposure during routine cast removal. It examined respiratory health among healthcare workers in five public hospitals in the Klang Valley, Malaysia. Personal and area air samples were collected and analyzed by phase-contrast microscopy in accordance with NIOSH NMAM 7400. Selected filter samples underwent scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM–EDX). Respiratory symptoms were assessed using a structured questionnaire, and pulmonary function was evaluated by spirometry. The study included 206 healthcare workers: 125 routinely involved in cast removal and 81 comparison workers. The highest mean concentrations were recorded in the POP room at Hospital A (personal: 1.63 fibres/mL; area: 2.17 fibres/mL), whereas measurements at the other hospitals were lower or below the analytical limit of detection. Exposed workers had higher prevalences of chronic cough, sputum production, wheezing, eye irritation, and skin irritation. Nasal irritation and shortness of breath did not differ significantly between groups. Mean FVC, FEV₁, and FEV₁/FVC did not differ significantly among participants with valid spirometry results. SEM–EDX identified elongated silicon- and oxygen-containing particles with elemental profiles compatible with fiberglass materials. These findings indicate that cast removal can produce appreciable airborne fiberglass fiber exposure under some clinical conditions. Because of the cross-sectional design, limited environmental sampling and incomplete spirometry data, the health findings should be interpreted as associations rather than evidence of causation.